Tuesday, September 22, 2009

The media’s MMR hoax

Dr Andrew Wakefield is in front of the General Medical Council on charges of serious professional misconduct, his paper on 12 children with autism and bowel problems is described as “debunked” – although it never supported the conclusions ascribed to it – and journalists have convinced themselves that his £435,643 fee from legal aid proves that his research was flawed. I will now defend the heretic Dr Andrew Wakefield.

The media are fingering the wrong man, and they know who should really take the blame: in MMR, journalists and editors have constructed their greatest hoax to date, and finally demonstrated that they can pose a serious risk to public health. But there are also many unexpected twists to learn from: the health journalists themselves were not at fault, the scale of the bias in the coverage was greater than anybody realised at the time, Leo Blair was a bigger player than Wakefield, and it all happened much later than you think.

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2002 was in fact the peak of the media coverage, by a very long margin. In 1998 there were only 122 articles on MMR. In 2002 there were 1,257. MMR was the biggest science story that year, the most likely science topic to be written about in opinion or editorial pieces, it produced the longest stories of any science subject, and was also by far the most likely to generate letters to the press, so people were clearly engaging with the issue. MMR was the biggest and most heavily covered science story for years.

It was also covered extremely badly, and largely by amateurs. Less than a third of broadsheet reports in 2002 referred to the overwhelming evidence that MMR is safe, and only 11% mentioned that it is regarded as safe in the 90 other countries in which it is used.

While stories on GM food, or cloning, stood a good chance of being written by specialist science reporters, with stories on MMR their knowledge was deliberately sidelined, and 80% of the coverage was by generalist reporters. Suddenly we were getting comment and advice on complex matters of immunology and epidemiology from Nigella Lawson, Libby Purves, Suzanne Moore and Carol Vorderman, to name only a few. The anti-MMR lobby, meanwhile, developed a reputation for targeting generalist journalists, feeding them stories, and actively avoiding health or science correspondents.

Journalists are used to listening with a critical ear to briefings from press officers, politicians, PR executives, salespeople, lobbyists, celebrities and gossip-mongers, and they generally display a healthy natural scepticism: but in the case of science, generalists don’t have the skills to critically appraise a piece of scientific evidence on its merits. At best, the evidence of these “experts” will only be examined in terms of who they are as people, or perhaps who they have worked for. In the case of MMR, this meant researchers were simply subjected to elaborate smear campaigns.

The actual scientific content of stories was brushed over and replaced with didactic statements from authority figures on either side of the debate, which contributed to a pervasive sense that scientific advice is somehow arbitrary, and predicated upon a social role – the “expert” – rather than on empirical evidence.

Any member of the public would have had very good reason to believe that MMR caused autism, because the media distorted the scientific evidence, reporting selectively on the evidence suggesting that MMR was risky, and repeatedly ignoring the evidence to the contrary. In the case of the PCR data, the genetic fingerprinting information on whether vaccine-strain measles virus could be found in tissue samples of children with autism and bowel problems, this bias was, until a few months ago, quite simply absolute. You will remember from earlier that Wakefield co-authored two scientific papers – known as the “Kawashima paper” and the “O’Leary paper” – claiming to have found such evidence, and received blanket media coverage for them. But you may never even have heard of the papers showing these to be probable false positives.

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[...]British journalists have done their job extremely well. People make health decisions based on what they read in the newspapers, and MMR uptake has plummeted from 92% to 73%: there can be no doubt that the appalling state of health reporting is now a serious public health issue. We have already seen a mumps epidemic in 2005, and measles cases are at their highest levels for a decade. But these are not the most chilling consequences of their hoax, because the media are now queueing up to blame one man, Wakefield, for their own crimes.

It is madness to imagine that one single man can create a 10-year scare story. It is also dangerous to imply – even in passing – that academics should be policed not to speak their minds, no matter how poorly evidenced their claims. Individuals like Wakefield must be free to have bad ideas. The media created the MMR hoax, and they maintained it diligently for 10 years. Their failure to recognise that fact demonstrates that they have learned nothing, and until they do, journalists and editors will continue to perpetrate the very same crimes, repeatedly, with increasingly grave consequences.